ANYBODY DIED
DECEASED
(H-31)
Has any member of
this household died
in the past 12
months, i.e. between
10 October 2000 and
10 October 2001?
(H-31a)
(If YES to H-30)
What was the first name of the deceased?
What was the month and year of
death?
What was the
age in years at
death?
What is the
sex of the
deceased?
M = Male
F = Female
Write the month and year of death.
Dot the appropriate
box.
Month
N
If YES, how many?
Go to H-31a.
If NO, the
questionnaire is
completed.
If the deceased
was a woman
under 50 years,
did (the person)
die while
pregnant or
within six
weeks after
delivery?
Y = Yes
Dot the
appropriate N = No
box.
Dot the
appropriate box.
Did (the
person) die
from an
accident or
For example, if 2 through
years of age write violence?
Y = Yes
0 0 2
N = No
Dot the
appropriate
box.
Y = Yes
N = No
Y
A
INFORMATION REGARDING THE HOUSEHOLD
Year
HOUSEHOLD QUESTIONNAIRE
FOR STATISTICAL USE ONLY
M
Y
Y
Y
Y
M
F
Y
N
Y
N
M
M
Y
Y
Y
Y
M
F
Y
N
Y
N
FOR OFFICE USE
M
M
Y
Y
Y
Y
M
F
Y
N
Y
N
EA
number:
M
M
Y
Y
Y
Y
M
F
Y
N
Y
N
M
M
Y
Y
Y
Y
M
F
Y
N
Y
N
Record
number:
Name of local
munic.:
Household
number:
Institution
number:
Province:
Main place:
Sub-place:
WHAT IS THE SURNAME OF THE HEAD/ACTING HEAD ?
Physical address: .......................................................................................................................................
Postal code: ..................................................
...................................................................................................................................................................
Telephone no: ...............................................
How many questionnaires were completed for this household?
If more than 1 questionnaire was completed for this household (more than 10 persons present in this household on the night
between 9 - 10 October 2001), write the barcode of the first questionnaire in the boxes below.
Date:
D
D
Signature: _______________________________________________________
M
M
Y
Y
Y
Y
Supervisor’s name and signature (to indicate that s/he has checked enumerator’s work)
Name: __________________________________________________________
Date:
D
D
Signature: _______________________________________________________
M
M
Y
Y
Y
Y
Female
How to fill in the questionnaire
Write the codes in the appropriate boxes or dot the box.
Use a dot
Name: __________________________________________________________
Male
This Questionnaire should be completed for all households living in housing units and collective living quarters
including those located in institutions (for example, boarding schools, prisons, hospitals, etc.)
Who completed this questionnaire?
•
An enumerator through an interview.
Enumerator’s name and signature(confirming that s/he has completed or checked the questionnaire).
Total
Number of
people:
If more than one questionnaire, what is the number of this questionnaire?
FOR OFFICE USE
•
Use a pencil. If you make a mistake, use a soft rubber to erase wrong
dots, numbers or letters and write the correct answer.
A household member through self-completion.
Please write dots, numbers and letters clearly so that the scanning
machine can read them. Always use CAPITAL LETTERS.
For example, for a grandchild of head/acting head of household, write
code 0 9
in the box in column P-04 on the relevant line.
Completion of this questionnaire
First fill in the full name of the household head or acting head and the first
name of all other persons to be counted.
Read every question carefully.
Look at the classifications where applicable and find the alternative that
best applies to the response.
Make sure that all dots, numbers and letters stay inside the box.
For example, in question P-04 a grandchild belongs to category 09.
(Correct)
Who should be counted in Census 2001?
•
Every person young or old in South Africa on census night,
9 - 10 October, should be counted in the household where s/he spent
the night. Include non-citizens and visitors if they spent census night in
the household.
•
Include: Babies born before midnight between 9 - 10 October and
household members who died after midnight between 9 - 10 October
2001 as alive. (Census records the situation as at midnight between
9 - 10 October as the reference point).
•
LASER LABELS
•
•
(Incorrect)
For example
1
2
3
4
5
6
7
8
9
0
Do not leave spaces or use hyphens. For example, Cape Town should be
written in this way:
Members of the household who are absent overnight, for example
working, travelling or at an entertainment venue, are to be counted in
the household if they return to it the next day, i.e. 10 October.
Persons who stayed in institutions on census night are counted in
those places.
C
A
W
N
P
E
T
O
Domestic workers are counted as a separate household even if they
live in the same household as the employer.
SHOULD YOU ENCOUNTER ANY DIFFICULTIES IN THE COMPLETION OF THE QUESTIONNAIRE, PLEASE CONTACT
................................................................................ ON ...............................................................OR PHONE THE CENSUS HOTLINE, TOLL FREE, ON
A12
STATISTICS ACT NO.6, 1999
17(1)
Despite any other law, no return or
other information collected by
Statistics South Africa for the purposes
of official or other statistics that relates
to an individual or a household may be
disclosed to any person.
17(b)
Any person who is involved in the
collection of, or who may use, that
information or data, must first take an
oath of confidentiality.
18(e) & 18(g)
Any officer of Statistics South Africa
who wilfully discloses any data or
information obtained in the course of
such employment to a person not
authorised to receive that information
is guilty of an offence and liable on
conviction to a fine not exceeding
R10 000, or to imprisonment for a
period not exceeding six months or to
both such fine and such imprisonment.
CENSUS 2001
M
Thank you for your co-operation.
CONFIDENTIALITY
A1
0800 110248
NAME
PERSON NO
(P-00)
Please write the name and surname of the household head and
first names of every person who was present in this household
on the night between 9 - 10 October.
One name on each row.
Start with head or acting head of household.
(P-01)
Assign row or
person number
to each person
starting from 01.
For example,
first person
becomes
0 1, the
tenth person
becomes
1 0. The
eleventh person
becomes
1 1
in the second
questionnaire
(if used).
The head or acting head is the person who is the main decisionmaker in the household. If people are equally decision-makers,
take the oldest person.
For babies with no name, write BABY.
Age
Sex
(P-02)
What is (the person’s) date of birth and age in completed years?
If date of birth not known give (the person’s) age in completed years.
If age not known give an estimate of age.
Date of birth is recorded as DD/MM/YYYY.
DD is for day / MM is for month and / YYYY is for year.
For example, if the person was born on 7 September 1963, write 0 7
for the day DD, 0 9 for the month MM, and 1 9 6 3 for the year
YYYY.
(P-04)
What is (the person’s) relationship to the head or acting head of the
household?
The head or acting head is the person listed in row 1 (of the first
questionnaire, if more than one questionnaire has been completed for
this household). See definition of head in column P-00
Dot the
appropriate
box.
01 = Head/acting head
02 = Husband/wife/partner
03 = Son/daughter
04 = Adopted child
05 = Stepchild
06 = Brother/sister
07 = Parent
08 = Parent-in-law
For babies less than one year write 0 0 0 for age, and for person
7 years and 10 months old write 0 0 7 for age.
09 = Grand/greatgrand child
10 = Son/daughter-in-law
11 = Brother/sister-in-law
12 = Other relative
13 = Non related person
TYPE OF HOUSING UNIT
(H-23)
(H-23a)
What is the type of these living Which type of dwelling or housing unit does this household occupy?
quarters?
If this household lives in MORE THAN ONE DWELLING, write the code of the MAIN
dwelling that the household occupies in the boxes.
1 = Housing unit
01 = House or brick structure on a separate stand or yard
09 = Caravan or tent
2 = Residential hotel
02 = Traditional dwelling/hut/structure made of traditional
10 = Private ship/boat
3 = Students’ residence
11 = Other (specify)
materials
4 = Home for the aged
03
=
Flat
in
block
of
flats
5 = Workers’ hostel
04 = Town/cluster/semi-detached house (simplex, duplex, triplex)
6 = Other (specify)
05 = House/flat/room in back yard
06 = Informal dwelling/shack in back yard
If 2-5 go to H-25
07 = Informal dwelling/shack NOT in back yard, e.g. in an
informal/squatter settlement
08 = Room/flatlet not in back yard but on a shared property
Date of birth
Write the appropriate code in the boxes.
Sex
Age
Y = Yes
N = No
Dot the
appropriate box.
D
M
M
Y
Y
Y
Y
M
F
2
D
D
M
M
Y
Y
Y
Y
M
F
3
D
D
M
M
Y
Y
Y
Y
M
F
4
D
D
M
M
Y
Y
Y
Y
M
F
D
D
D
D
M
M
M
M
Y
Y
Y
Y
Y
Y
Y
M
M
Y
F
F
7
D
D
M
M
Y
Y
Y
Y
M
F
8
D
D
M
M
Y
Y
Y
Y
M
F
9
D
D
M
M
Y
Y
Y
Y
M
F
0
D
D
M
M
Y
Y
Y
Y
M
F
A2
ROOMS
SHARING 1
ROOM
(H-24)
(H-24a)
How many rooms, If one room
including
only:
kitchens, are there Are there two
for this
or more
household?
households
Count all rooms in sharing a
all dwellings.
single room?
Exclude bathrooms, Y = Yes
sheds, garages,
N = No
stables, etc. unless
persons are living
Dot the
in them.
appropriate
For example, if 4
box.
rooms 0 4
N
Y
N
TENURE STATUS
PIPED WATER
SOURCE OF WATER
TOILET F ACILITY
(H-25)
What is the tenure status of the
household?
If the household uses several dwellings, write
the code for the main dwelling in the box.
(H-26)
In which way does this household obtain
PIPED WATER for domestic use?
Write only one code in the box.
(H-26a)
What is this household’s MAIN source of
WATER for domestic use? Write only one code
in the box.
1 = No access to piped (tap) water
2 = Piped (tap) water on community stand:
distance greater than 200 m from
dwelling
3 = Piped (tap) water on community stand:
distance less than 200 m from
dwelling
4 = Piped (tap) water inside yard
5 = Piped (tap) water inside dwelling
1 = Regional/local water scheme (operated by a
Water Service Authority or Provider)
2 = Borehole
3 = Spring
4 = Rain-water tank
5 = Dam / pool / stagnant water
6 = River/stream
7 = Water vendor
8 = Other (specify)
(H-27)
What is the MAIN type of TOILET
facility that is available for use by
this household?
Write only one code in the box.
1= Owned and fully paid off
2 = Owned but not yet paid off
3 = Rented
4 = Occupied rent-free
5 = Other (specify)
1 = Flush toilet (connected to
sewerage system)
2 = Flush toilet (with septic tank)
3 = Chemical toilet
4 = Pit latrine with ventilation (VIP)
5 = Pit latrine without ventilation
6 = Bucket latrine
7 = None
ENERGY/FUEL
HOUSEHOLD GOODS
(H-28)
What type of energy/fuel does this household MAINLY use for cooking, for heating
and for lighting? Write one code in each box.
(H-29)
Does the household have any of the following (in working condition)?
1 = Electricity
9 = Other (specify)
2 = Gas
3 = Paraffin
4 = Wood
5 = Coal
6 = Candles
7 = Animal dung
8 = Solar
Cooking
Note: - Wood (4), coal (5) and animal
dung (7) cannot be used for
lighting
- Candles (6) cannot be used for
cooking or heating
Heating
Y = Yes
N = No
Dot the appropriate box for each item.
Lighting
Y
N
Radio
Y
N
Refrigerator
Y
N
Television
Y
N
Telephone in the dwelling
Y
N
Computer
Y
N
Cell-phone
If YES to telephone or cellphone go to H-30
ACCESS TO TELEPHONE (If NO to “telephone “ and “cell-phone” in H-28)
REFUSE OR RUBBISH
(H-29a)
Where do members of this household MAINLY use a telephone? Write only one code in
the box.
1 = At a neighbour nearby
2 = At a public telephone nearby
3 = At another location nearby
4 = At another location, not nearby
5 = No access to a telephone
(H-30)
How is the refuse or rubbish of this household MAINLY disposed of? Write only one
code in the box.
1 = Removed by local authority at least once a week
4 = Own refuse dump
2 = Removed by local authority less often
5 = No rubbish disposal
3 = Communal refuse dump
6 = Other (specify)
Have you included babies, small children, old
people and visitors who were present in this
household on the night between 9 - 10 October.
AF
MORE THAN
ONE DWELLING
(H-23b )
Does this
household
occupy more
than one
dwelling on this
site?
Y
D
6
TYPE OF LIVING QUARTERS
(P-03)
Is (the
person) male
or female?
M = Male
F = Female
1
5
SECTION B: INFORMATION ON HOUSING
S E C T I O N A : I N F O R M A T I O N F O R P E R S O N S I N T H E H O U S E H O L D - A S K OF E V E R Y O N E
DATE OF BIRTH
SEX
RELATIONSHIP
A11
WOMEN AGED BETWEEN 12 AND 50 YEARS (BORN BETWEEN 1951 AND 1989)
LAST CHILD BORN
(P-20b)
If (the person) has ever given live birth: When was (the person’s) last child born?
Date of Birth:
DD / MM / YYYY
What is the sex of that child?:
M = Male
F = Female
Is that child alive or dead?
A = Alive
D = Dead
Write the day, month and year of the last live birth and dot the appropriate box of the
sex. If multiple birth, indicate only the last child. Dot the appropriate box whether the
child is still alive on Census night 9 - 10 October.
DO NOT COUNT STILLBIRTHS (children born dead).
Sex
Date of birth
Alive/Dead
D
D
M
M
Y
Y
Y
Y
M
F
A
D
D
D
M
M
Y
Y
Y
Y
M
F
A
D
D
D
M
M
Y
Y
Y
Y
M
F
A
D
D
D
M
M
Y
Y
Y
Y
M
F
A
D
D
D
M
M
Y
Y
Y
Y
M
F
A
D
D
D
M
M
Y
Y
Y
Y
M
F
A
D
D
D
M
M
Y
Y
Y
Y
M
F
A
D
D
D
M
M
Y
Y
Y
Y
M
F
A
D
D
D
M
M
Y
Y
Y
Y
M
F
A
D
D
D
M
M
Y
Y
Y
Y
M
F
A
D
TRAVEL T O SCHOOL OR PLACE
OF WORK
(P-21)
How does (the person) usually
travel to school or to his/her
place of work? Indicate the main
mode of travel even if s/he was
temporarily absent that week.
0 = Not applicable
1 = On foot
2 = By bicycle
3 = By motorcycle
4 = By car as a driver
5 = By car as a passenger
6 = By minibus/ taxi
7 = By bus
8 = By train
9 = Other
If more than one mode of travel,
write the code of the mode that
covers the longest distance.
A10
A S K OF E V E R Y O N E
INCOME CATEGOR Y
MARITAL STATUS
(P-22)
What is the income category that best describes the gross
income of (this person) before tax? Choose from the table
below the code that corresponds to the income level.
CODE MONTHLY
01
02
03
04
05
06
07
08
09
10
11
12
No income
R 1 – R 400
R 401 – R 800
R 801 – R 1 600
R 1 601 – R 3 200
R 3 201 – R 6 400
R 6 401 – R 12 800
R 12 801 – R 25 600
R 25 601 – R 51 200
R 51 201 – R 102 400
R 102 401 – R 204 800
R 204 801 or more
ANNUAL
No income
R 1 – R 4 800
R 4 801 – R 9 600
R 9 601 – R 19 200
R 19 201 – R 38 400
R 38 401 – R 76 800
R 76 801 – R 153 600
R 153 601 – R 307 200
R 307 201 – R 614 400
R 614 401 – R 1 228 800
R 1 228 801 – R 2 457 600
R 2 457 601 or more
A monthly income of R1 500 is code 04 and an annual
income of R25 000 is code 05.
(P-05)
What is (the person’s) PRESENT marital
status?
1 = Married civil/religious
2 = Married traditional/customary
3 = Polygamous marriage
4 = Living together like married partners
5 = Never married
6 = Widower/widow
7 = Separated
8 = Divorced
A S K OF E V E R Y O N E
POPULATION
GROUP
(P-05a)
(P-06)
If categories 1-4 in P-05
How would (the
person)
Who, in the household, is (the person’s) spouse describe him/
or partner?
herself in terms
Write the person number of the spouse or partner in of population
the appropriate box.
group?
SPOUSE
LANGUAGE
(P-07)
Which language does
(the person) speak most
often in this household?
01 = Afrikaans
02 = English
03 = IsiNdebele
04 = IsiXhosa
For example, if the spouse of the head of the
1 = Black African 05 = IsiZulu
household is the person listed in row 2 write 0 2 2 = Coloured
06 = Sepedi
in row 1.
3 = Indian or
07 = Sesotho
Asian
08 = Setswana
Write only one code per person in the box. If a man has more than one wife, write the row
4 = White
09 = SiSwati
number of the first wife. Write the row number of the 5 = Other
10 = Tshivenda
If both civil/religious and traditional marriage, husband for each of his wives.
(specify)
11 = Xitsonga
indicate civil/religious.
12 = Other (specify)
If spouse is not in the household write 9 9 .
Write only one code per
If categories 5-8 go to (P-06).
person.
A3
RELIGION
(P-08)
What is (the person’s) religion,
denomination, or belief?
Please write the complete name.
For example, Apostolic Faith Mission,
Dutch Reformed Church, Hinduism,
Islam, Zion Christian Church.
If no religion, write NONE.
Use CAPITAL LETTERS only.
BORN IN
SA?
(P-09)
Was (the
person)
born in
South
Africa?
Include
former
“homelands”
as South
Africa.
Y = Yes
N = No
Dot the
appropriate
box.
If NO go to
P-09b
Y
PLACE OF
BIRTH
(P-09a)
If YES to P-09
In which
province was
(the person)
born?
COUNTRY OF BIRTH
A S K OF E V E R Y O N E
CITIZENSHIP
(P-09b)
If NO to P-09
(P-10) (P-10a)
Is (the person) a South African citizen?
In which country was (the
person) born?
1 =Western Cape Write the present name of the
2 =Eastern Cape country.
3 =Northern Cape
Use CAPITAL LETTERS only.
4 =Free State
5 =KwaZuluNatal
6 =North West
7 =Gauteng
8 =Mpumalanga
9 =Northern
Province
Go to P-10
TOTAL BIRTHS
(P-20)
How many children, if any, has (the person) ever had, that were born alive?
Y = Yes
N = No
Dot the appropriate box.
(P-11) (P-11a)
Does (the person) usually live in this household for at least four
nights a week?
Y = Yes
N = No
Dot the appropriate box.
If YES go to P-11
If YES go to P-12
If NO
If NO
(P-10a) What is the name of the country of (P-11a) Where does (the person) usually live?
citizenship?
IF IN THE SAME PLACE as the place of enumeration, dot the S box.
IF NOT the same place, write the
Use CAPITAL LETTERS only.
PROVINCE P R ,
MAIN PLACE (city, town, tribal area, administrative area) and
SUB-PLACE (suburb, ward, village, farm, informal settlement).
IF ANOTHER COUNTRY, write the name of the country in the boxes
below.
O
R
Y
U
N
T
Y
C
N
O
U
Y
N
T
R
Y
N
Y
C
O
R
Y
U
N
T
Y
C
N
O
U
N
T
R
Y
C
O
R
Y
U
N
T
Y
C
N
O
U
T
R
Y
N
Y
C
O
R
Y
U
N
T
Y
C
N
O
U
T
R
Y
N
Y
C
O
R
Y
U
N
T
Y
C
N
O
U
T
R
Y
N
Y
C
O
R
Y
U
N
T
Y
C
N
O
U
T
R
Y
N
Y
C
O
R
Y
U
N
T
Y
C
N
O
U
C
O
R
Y
U
N
T
Y
C
T
R
Y
N
O
U
C
O
R
Y
U
N
T
Y
C
N
T
R
Y
N
O
U
C
O
R
Y
U
N
T
Y
C
N
T
R
Y
N
O
U
C
S
U
B
P
L
A
C
E
N
N
A4
T
R
Y
S
P
R
E
A
I
N
P
L
A
C
S
U
B
P
L
A
C
E
S
P
R
M
A
N
I
N
P
L
A
C
E
S
U
B
P
L
A
C
E
S
S
P
R
M
A
N
I
N
P
L
A
C
E
S
U
B
P
L
A
C
E
S
S
P
R
M
A
N
I
N
P
L
A
C
E
S
U
B
P
L
A
C
E
S
S
P
R
M
A
N
I
N
P
L
A
C
E
S
U
B
P
L
A
C
E
S
S
P
R
M
A
N
I
N
P
L
A
C
E
S
U
B
P
L
A
C
E
S
N
S
S
P
R
E
M
A
I
N
P
L
A
C
S
U
B
P
L
A
C
E
N
S
S
P
R
E
M
A
I
N
P
L
A
C
S
U
B
P
L
A
C
E
Y
N
S
M
Y
N
Y
A
Y
N
Y
L
Y
N
N
Y
P
Y
N
E
N
Y
N
R
I
Y
N
P
A
Y
N
S
M
Y
N
Y
N
N
S
S
P
R
E
M
A
I
N
P
L
A
C
S
U
B
P
L
A
C
E
STILL LIVING
If none write 0 0 and go to P-21.
Include ALL her children, i.e. those who are still living, whether or not they live in this
household, and those who are dead.
DO NOT COUNT STILLBIRTHS (children born dead).
For example
Boys
Total
0
3
(P-20a)
If the person has ever given live birth:
If boys:
How many boys are still alive?
How many of these were boys?
How many of these were girls?
Total
Use CAPITAL LETTERS only.
C
ASK OF WOMEN AGED BETWEEN 12 AND 50 YEARS (BORN BETWEEN 1951 AND 1989)
USUALLY LIVE
0
2
Boys
If girls:
How many girls are still alive?
For example, if 2 children of the 3 given in P-20 are still alive, 1 boy and 1 girl, write:
Girls
0
Total
1
0
Girls
2
Total
A9
Boys
0
Girls
1
Boys
0
1
Girls
ASK FOR ALL PERSONS AGED 10 YEARS AND OLDER (BORN BEFORE
COMPANY/BUSINESS ACTIVITY
OCCUPATION
HOURS
(P-19b)
(P-19c)
WORKED
(P-19d)
If YES to P-18
If YES to P-18
If YES to P-18
10 OCTOBER 1991)
PLACE OF WORK
What does the business do (main
economic activity)?
Does (the person) work in the same sub-place in which s/he
usually lives?
Y = Yes
N = No
Dot the appropriate box.
Write the MAIN INDUSTRY, economic
activity, product or service of (the
person’s) employer or company. For
example, gold mining, road construction,
supermarket, police service, healthcare,
hairdressing, banking.
OR
Write the activity of the person if selfemployed. For example, subsistence
farming.
What is the main occupation of (the person) in this
workplace?
Occupation refers to the type of work (the person)
performed in the seven days before 10 October.
Use two or more words.
How many
hours did (the
person) work in
the seven days
before
10 October?
For example, street trader, cattle farmer, primary school If (the person)
teacher, domestic worker, fruit vendor, truck driver,
was absent from
warehouse manager, filing clerk, etc.
work those
seven days, but
Use CAPITAL LETTERS only.
usually works,
write the number
of hours
If doing PAID domestic work in a private
s/he usually
household, write DOMESTIC SERVICE.
works.
Use CAPITAL LETTERS only.
(P-19e) (P-19f)
If YES to P-18
If NO, where is this place of work?
If NOT the same place, write PROVINCE P R ,
MAIN PLACE (city, town, tribal area, administrative area) and
SUB-PLACE (suburb, ward, village, farm, informal settlement).
If another country, write the name of the country in the boxes below.
FIVE YEARS AGO
FROM WHERE MOVED
(P-12)
Five years ago (at
the time of Census
’96), was (the
person) living in
this place (i.e. this
suburb, ward,
village, farm,
informal
settlement)?
(P-12a)
If NO to P-12
Y = Yes
N = No
B = Born after
October 1996
Dot the appropriate
box.
A S K OF E V E R Y O N E
IN WHICH
DISABILITY
YEAR
(P-12b)
(P-13)
If NO to P-12 Does (the person) have any serious
disability that prevents his/her full
In which year participation in life activities (such
did (the
as education, work, social life)?
person) move Mark any that apply.
to this place? 0 = None
1 = Sight (blind/severe visual limitation)
1 = 1996
2 = Hearing (deaf, profoundly hard
2 = 1997
of hearing)
3 = 1998
3 = Communication (speech impairment)
4 = 1999
4 = Physical (e.g. needs wheelchair,
5 = 2000
crutches or prosthesis; limb,
hand usage limitations)
6 = 2001
Where did (the person) move from?
If more than one move, give details of the last move.
Write the
PROVINCE P R ,
MAIN PLACE (city, town, tribal area, administrative
area) and
SUB-PLACE (suburb, ward, village, farm, informal
settlement).
5 = Intellectual (serious difficulties in
learning)
If more than
6 = Emotional (behavioural,
one move,
psychological)
write the code
for the year of
the last move. Dot the appropriate boxes.
IF ANOTHER COUNTRY, write the name of the
country.
Use CAPITAL LETTERS only.
If Y or B go to P-13
Y
N
P
R
M
A
I
N
P
L
A
C
S
U
B
P
L
A
C
E
P
R
Y
N
M
A
I
N
P
L
A
C
S
U
B
P
L
A
C
E
Y
P
R
M
A
N
I
N
P
L
A
C
S
U
B
P
L
A
C
E
Y
P
R
M
A
N
I
N
P
L
A
C
S
U
B
P
L
A
C
E
Y
P
R
M
A
N
I
N
P
L
A
C
S
U
B
P
L
A
C
E
Y
P
R
M
A
N
I
N
P
L
A
C
S
U
B
P
L
A
C
E
Y
P
R
M
A
N
I
N
P
L
A
C
S
U
B
P
L
A
C
E
P
R
Y
N
M
A
I
N
P
L
A
C
S
U
B
P
L
A
C
E
P
R
Y
N
M
A
I
N
P
L
A
C
S
U
B
P
L
A
C
E
P
R
Y
A8
WHO HAD WORK
N
M
A
I
N
P
L
A
C
S
U
B
P
L
A
C
E
Y
N
E
B
Y
N
E
B
Y
N
E
B
Y
N
E
B
Y
N
E
B
Y
N
E
B
Y
N
E
B
Y
N
E
B
Y
N
E
B
Y
N
E
B
P
R
M
A
I
N
P
L
A
C
S
U
B
P
L
A
C
E
P
R
M
A
I
N
P
L
A
C
S
U
B
P
L
A
C
E
0
E
1
3
5
P
R
M
A
I
N
P
L
A
C
S
U
B
P
L
A
C
E
P
R
A
I
N
P
L
A
C
5
S
U
B
P
L
A
C
E
P
R
A
I
N
P
L
A
C
S
U
B
P
L
A
C
E
P
R
A
I
N
P
L
A
C
S
U
B
P
L
A
C
E
P
R
A
I
N
P
L
A
C
S
U
B
P
L
A
C
E
P
R
M
A
I
N
P
L
A
C
S
U
B
P
L
A
C
E
P
R
M
A
I
N
P
L
A
C
S
U
B
P
L
A
C
E
P
R
M
A
I
N
P
L
A
C
S
U
B
P
L
A
C
E
1
5
6
0
1
3
N
2
Y
N
D
2
Y
N
D
2
Y
N
4
5
6
0
1
3
D
2
Y
N
4
5
6
0
1
3
A5
Y
D
4
3
5
2
4
0
E
N
D
1
6
E
Y
6
5
E
2
4
3
E
N
4
1
0
M
Y
6
5
N
D
1
3
E
2
4
3
0
M
Y
6
5
N
D
1
5
E
2
6
0
M
Y
D
4
3
E
If the mother does not live in this
household, write 9 9 in the
appropriate boxes.
Person no.
2
1
0
M
If YES:
(P-14a) Who in this household is (the
person’s) mother?
For example, if the mother is the person
listed in row 2, write 0 2 .
4
3
E
(P-14) (P-14a)
Is (the person’s) own biological mother
still alive?
Y = Yes
N = No
D = Do not know
Dot the appropriate box.
6
0
E
MOTHER ALIVE
D
2
4
6
Y
N
D
FATHER ALIVE
A S K OF E V E R Y O N E
PRESENT SCHOOL ATTENDANCE
(P-15) (P-15a)
Is (the person’s) own biological father
still alive?
Y = Yes
N = No
D = Do not know
If YES:
(P-15a) Who in this household is (the
person’s) father?
For example, if the father is the person
listed in row 2, write 0 2 .
(P-16) (P-16a)
Does (the person) presently attend an
educational institution?
(P-17)
What is the highest level of education
that (the person) has completed?
1 = No (Go to P-17)
2 = Yes: Pre-school
3 = Yes: School
4 = Yes: College
5 = Yes: Technikon
6 = Yes: University
7 = Yes: Adult education centre
99=
00=
01=
02=
03=
04=
05=
06=
07=
08=
8 = Yes: Other (specify)
Please include studies by
If the father does not live in this household, correspondence/ distance education.
If YES:
write 9 9 in the appropriate boxes.
(P-16a) Is this institution public or private?
1 = public (government)
2 = private
3 = don’t know
Person no.
Y
ALL AGED 5 YEARS OR MORE
LEVEL OF EDUCATION
Institution
Type
09=
10=
11=
12=
No schooling
Grade 0
Grade 1/Sub A
Grade 2/Sub B
Grade 3/Standard 1
Grade 4/Standard 2
Grade 5/Standard 3
Grade 6/Standard 4
Grade 7/Standard 5
Grade8/Standard 6/
Form 1
Grade9/Standard 7/
Form 2
Grade 10/Standard 8/
Form 3/NTCI
Grade 11/Standard 9/
Form 4/NTCII
Grade 12/Standard10/
Form 5/Matric./NTCIII
13= Certificate with less
than Grade 12
14= Diploma with less
than Grade 12
15= Certificate with
Grade 12
16= Diploma with
Grade 12
17= Bachelors Degree
18= Bachelors Degree
and Diploma
19= Honours degree
20= Higher Degree
(Masters, Doctorate)
21= Other
22= Don’t know
If categories 99 or 00-12 go to P-18
ALL PERSONS WITH POST-SCHOOL QUALIFICATIONS
FIELD OF EDUCATION
(P-17a)
If categories 13-20 in P-17
In which field is (the person’s) highest
post-school qualification?
01 = Agriculture or Renewable Natural Resources
02 = Architecture or Environmental Design
03 = Arts, Visual or Performing
04 = Business, Commerce or Management Sciences
05 = Communication
06 = Computer Science or Data Processing
07 = Education, Training or Development
08 = Engineering or Engineering Technology
09 = Health Care or Health Sciences
10 = Home Economics
11 = Industrial Arts, Trades or Technology
12 = Languages, Linguistics or Literature
13 = Law
14 = Libraries or Museums
15 = Life Sciences or Physical Sciences
16 = Mathematical Sciences
17 = Military Sciences
18 = Philosophy, Religion or Theology
19 = Physical Education or Leisure
20 = Psychology
21 = Public Administration or Social Services
22 = Social Sciences or Social Studies
23 = Other (Specify)
A S K F O R A L L P E R S O N S A G E D 1 0 Y E A R S A N D O L D E R ( B O R N B E F O R E 10 OCTOBER 1 9 9 1 )
ANY WORK IN THE 7 DAYS
DID NOT HAVE ANY WORK
HAD
WORK
BEFORE 10 OCTOBER
REASON WHY NOT WORKING
ACTIVE STEPS
AVAILABILITY
WORK STATUS
BUSINESS/COMPANY NAME
(P-18)
(P-18a)
(P-18b)
(P-18c)
(P-19)
(P-19a)
In the SEVEN DAYS before
10 October did (the
If NO to P-18
If NO to P-18
If NO to P-18
If YES to P-18
If YES to P-18
person) do any work for
What is the main reason why (the
In the PAST FOUR
If offered work,
PAY (in cash or in kind)
person) did not have work in the
WEEKS before
how soon could
How can one best
What is the FULL name of the
PROFIT or FAMILY GAIN,
seven days before 10 October?
10 October has (the (the person) start? describe (the person’s)
business/company or organisation
for one hour or more?
1 = Scholar or student
person) taken active 1 = Within one
main activity or work
for whom (the person) works?
steps to find
2 = Home-maker or housewife
week
status?
1 =Yes: formal registered
3 = Pensioner or retired person/
employment?
2 = More than
If the person works for him/herself,
(non-farming)
too old to work
Y = Yes
1 week, up
1 = Paid employee
and the business does not have a
2 =Yes: informal
4 = Unable to work due to illness
N = No
to 2 weeks
2 = Paid family worker
name, write SELF in the appropriate
unregistered (nonFor example, (the
or disability
3 = More than
3 = Self-employed
row.
farming)
person) went to visit
5 = Seasonal worker not working
2 weeks, up
4 = Employer
If doing PAID domestic work in a
3 =Yes: farming
factories or other
presently
to 4 weeks
5 = Unpaid family worker private household, write DOMESTIC
employment places,
4 =Yes: has work but was
6 = Does not choose to work
4 = Some time
6 = Other (specify)
SER VICE.
temporarily absent
placed or answered
7 = Could not find work
after 4 weeks
advertisements, looked 5 = Does not
5 =No: did not have work
Use CAPITAL LETTERS only.
If more than one reason, write the code for land or a building or
choose to work
If YES go to P-19
of the MAIN (most important) reason. equipment to start own Go to P-20
business or farm.
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
D
Y
N
D
Y
N
D
Y
N
D
Y
N
D
Y
N
D
Y
N
D
Y
N
D
Y
N
D
Y
N
D
A6
A7
A S K OF W O M E N A G E D 1 2 - 5 0 Y E A R S ( B O R N B E T W E E N 1 9 5 1 A N D 1 9 8 9 )
STILL LIVING
TOTAL BIRTHS
(P-20)
How many children, if any, has (the person) ever had, that were born alive?
If none, write
0 0 go to P-21.
If boys:
How many boys are still alive?
How many of these were boys?
How many of these were girls?
If girls:
How many girls are still alive?
Include ALL her children, i.e. those who are still living, whether or not they live in this
household, and those who are dead.
DO NOT COUNT STILLBIRTHS (children born dead).
3
0
CENSUS 2001
For example, if 2 children of the 3 given in P-20 are still alive, 1 boy and 1 girl, write:
For example
Boys
Total
0
B
(P-20a)
If the person has ever given birth:
Girls
2
Total
0
1
0
Boys
2
0
Girls
1
0
QUESTIONNAIRE FOR INDIVIDUALS IN INSTITUTIONS AND TOURIST HOTELS
1
FOR STATISTICAL USE ONLY
Total
Boys
Girls
Total
Boys
FOR OFFICE USE
Girls
Record number:
EA number:
Local council:
ASK OF WOMEN AGED 12-50 YEARS (BORN BETWEEN 1951 AND 1989)
LAST CHILD BORN
TRAVEL T O SCHOOL OR
PLACE OF WORK
(P-20b)
(P-21)
If the (person) has ever given live birth: When was (the person’s) last child born?
How does (the person)
usually travel to school or
Date of Birth:
to his/her place of work?
DD / MM / YYYY
Indicate the main mode of
travel even if s/he was
What is the sex of that child?:
temporarily absent that week.
M = Male
0 = Not applicable
F = Female
1 = On foot
2 = By bicycle
Is that child alive or dead?
3 = By motorcycle
A = Alive
4 = By car as a driver
D = Dead
5 = By car as a
passenger
Write the day, month and year of the last live birth and dot the appropriate box of the sex. If 6 = By minibus/ taxi
multiple birth, indicate only the last child. Dot the appropriate box whether the child is still
7 = By bus
alive on Census night 9 - 10 October.
8 = By train
DO NOT COUNT STILLBIRTHS (children born dead).
9 = Other
If more than one mode of
travel, write the code of the
mode that covers the longest
Date of birth
Sex
Alive/Dead distance.
D
D
M
M
Y
Y
Y
Y
M
F
A
(P-22)
What is the income category that best describes the gross
income of (this person) before tax? Choose from the table
below the code that corresponds to the income level.
CODE MONTHLY
01
02
03
04
05
06
07
08
09
10
11
12
No income
R 1 – R 400
R 401 – R 800
R 801 – R 1 600
R 1 601 – R 3 200
R 3 201 – R 6 400
R 6 401 – R 12 800
R 12 801 – R 25 600
R 25 601 – R 51 200
R 51 201 – R 102 400
R 102 401 – R 204 800
R 204 801 or more
Name of institution: ....................................................................................................................................
For individuals in institutions and tourist hotels
(for example, tourist hotels, hospitals, childcare institutions, boarding schools, homes for the disabled, initiation
schools, convents, defence force barracks, prisons, community and church halls, refugee camps etc.)
ANNUAL
No income
R 1 – R 4 800
R 4 801 – R 9 600
R 9 601 – R 19 200
R 19 201 – R 38 400
R 38 401 – R 76 800
R 76 801 – R 153 600
R 153 601 – R 307 200
R 307 201 – R 614 400
R 614 401 – R 1 228 800
R 1 228 801 – R 2 457 600
R 2 457 601 or more
Who completed this questionnaire?
A monthly income of R1 500 is code 04 and an annual
income of R25 000 is code 05.
Name: __________________________________________________________
Name: __________________________________________________________
Signature: _______________________________________________________
Signature: _______________________________________________________
Y
Y
Y
Y
Date:
D
D
An individual through self-completion.
Use a dot
Who should be counted in Census 2001?
•
Every person young or old in South Africa on census night, 9 - 10
October, shall be counted in the institution where they spent the night.
Supervisor’s name and signature (to indicate that s/he has checked enumerator’s work)
M
•
How to fill in the questionnaire
Write the codes in the appropriate boxes or dot the box.
Look at the classifications where applicable and find the alternative that
best applies to the response.
For example, in question P-07 English belongs to category 02.
D
Enumerator’s name and signature(confirming that s/he has completed or checked the
questionnaire).
M
An enumerator through an interview.
First fill in the full name of the person to be counted.
Read every question carefully.
Write the barcode of Questionnaire C in the boxes below.
D
•
Completion of the questionnaire
FOR OFFICE USE
D
Homeless person (dot the box):
A S K OF E V E R Y O N E
INCOME CATEGOR Y
Thank you for your co-operation.
Date:
Province:
Institution number:
M
M
Y
Y
Y
Use a pencil. If you make a mistake, use a soft rubber to erase wrong dots,
numbers or letters and write the correct answer.
Please write dots, numbers and letters clearly so that the scanning machine
can read them. Always use CAPITAL LETTERS.
For example, for a person born in Kwazulu-Natal write code 5 in the box
in column P-09a.
Make sure that all dots, numbers and letters stay inside the box.
(Correct)
(Incorrect)
For example
•
Include: Babies born before 10 October 2001. Include also persons
who died after midnight between 9 - 10 October 2001.
1
2
3
4
5
•
Members of an institution who are absent overnight, for example
working, travelling or at an entertainment venue, are to be counted in
their institution if they return to it the next day, i.e. 10 October.
6
7
8
9
0
Do not leave spaces or use hyphens when a word runs across more than
one line. For example, Cape Town should be written in this way:
C
A
W
N
P
E
T
O
SHOULD YOU ENCOUNTER ANY DIFFICULTIES IN THE COMPLETION OF THE QUESTIONNAIRE, PLEASE CONTACT
................................................................................ ON ...............................................................OR PHONE THE CENSUS HOTLINE, TOLL FREE, ON
Y
B4
0800 110248
B1
ASK OF EVERYONE
NAME
ASK OF EVERYONE
DATE OF BIRTH
(P-00)
(P-02)
Please write the name of the person who spent What is (the person’s) date of birth and age in completed years?
the night of 9 - 10 October in this institution.
If date of birth not known give (the person’s) age in completed years.
If age not known give an estimate of age.
Date of birth is recorded as DD/MM/YYYY.
DD is for day / MM is for month and / YYYY is for year.
For example, if the person was born on 7 September 1963, write 0 7
for the day DD, 0 9 for the month MM, and 1 9 6 3 for the year
YYYY.
SEX
MARITAL STATUS
(P-03)
Is (the
person) male
or female?
M = Male
F = Female
(P-05)
What is (the person’s) PRESENT
marital status?
Dot the
appropriate
box.
For babies less than one year write 0 0 0 for age, and for person
7 years and 10 months old write 0 0 7 for age.
1 = Married civil/religious
2 = Married traditional/customary
3 = Polygamous marriage
4 = Living together like married partners
5 = Never married
6 = Widower/widow
7 = Separated
8 = Divorced
Write only one code in the box.
If both civil/religious and traditional
marriage, indicate civil.
M
M
Y
Y
Y
LANGUAGE
BORN IN
SA?
(P-07)
(P-08)
(P-09)
Which language does What is (the person’s) religion,
Was (the
(the person) speak
denomination, or belief?
person)
most often in this
born in
institution?
Please write the complete name.
South
01 = Afrikaans
For example, Apostolic Faith Mission, Africa?
02 = English
Dutch Reformed Church, Hinduism, Include
03 = IsiNdebele
Islam, Zion Christian Church.
former
04 = IsiXhosa
“homelands”
05 = IsiZulu
If no religion, write NONE.
as South
06 = Sepedi
Africa.
07 = Sesotho
Use CAPITAL LETTERS only.
Y = Yes
08 = Setswana
N = No
09 = SiSwati
10 = Tshivenda
Dot the
11 = Xitsonga
appropriate
12 = Other (specify)
box.
Write only one code.
If NO go to
1 = Black
African
2 = Coloured
3 = Indian or
Asian
4 = White
5 = Other
(specify)
Dot the
appropriate
box.
RELIGION
P-09b
LEVEL OF EDUCATION
FIELD OF EDUCATION
(P-16) (P-16a)
Does (the person) presently attend an
educational institution?
(P-17)
What is the highest level of education
that (the person) has completed?
(P-17a)
If categories 13-20 in P-17
1 = No (Go to P-17)
2 = Yes: Pre-school
3 = Yes: School
4 = Yes: College
5 = Yes: Technikon
6 = Yes: University
7 = Yes: Adult education centre
8 = Yes: Other (specify)
99=
00=
01=
02=
03=
04=
05=
06=
07=
08=
Please include studies by correspondence/
distance education.
09=
If YES:
(P-16a) Is this institution public or private?
1 = public (government)
2 = private
3 = don’t know
Y
N
Y
10=
11=
12=
Type
No schooling
Grade 0
Grade 1/Sub A
Grade 2/Sub B
Grade 3/Standard 1
Grade 4/Standard 2
Grade 5/Standard 3
Grade 6/Standard 4
Grade 7/Standard 5
Grade8/Standard 6/
Form 1
Grade9/Standard 7/
Form 2
Grade 10/Standard 8/
Form 3/NTCI
Grade 11/Standard 9/
Form 4/NTCII
Grade 12/Standard10/
Form 5/Matric./NTCIII
13= Certificate with less
than Grade 12
14= Diploma with less
than Grade 12
15= Certificate with
Grade 12
16= Diploma with
Grade 12
17= Bachelor’s Degree
18= Bachelor’s Degree
and Diploma
19= Honour’s degree
20= Higher Degree
(Master’s, Doctorate)
21= Other
22= Don’t know
If categories 99 or 00-12 go to P-18
In which field is (the person’s) post-school
qualification?
01 = Agriculture or Renewable Natural Resources
02 = Architecture or Environmental Design
03 = Arts, Visual or Performing
04 = Business, Commerce or Management Sciences
05 = Communication
06 = Computer Science or Data Processing
07 = Education, Training or Development
08 = Engineering or Engineering Technology
09 = Health Care or Health Sciences
10 = Home Economics
11 = Industrial Arts, Trades or Technology
12 = Languages, Linguistics or Literature
13 = Law
14 = Libraries or Museums
20 = Psychology
15 = Life Sciences or Physical Sciences
21 = Public Administration
or Social Services
16 = Mathematical Sciences
22 = Social Sciences or
17 = Military Sciences
18 = Philosophy, Religion or Theology
Social Studies
19 = Physical Education or Leisure
23 = Other (Specify)
N
Y
D
F
POPULATION
GROUP
(P-06)
How would
(the person)
describe him/
herself in
terms of
population
group?
Dot the
appropriate
box.
ALL PERSONS WITH POST-SCHOOL QUALIFICATIONS
PRESENT SCHOOL ATTENDANCE
Institution
M
D
FATHER
ALIVE
(P-15)
Is (the
person’s)
own
biological
father still
alive?
Y = Yes
N = No
D = Do not
know
Age
Date of birth
D
MOTHER
ALIVE
(P-14)
Is (the
person’s)
own
biological
mother still
alive?
Y = Yes
N = No
D = Do not
know
ALL AGED 5 YEARS OR MORE
PLACE OF
BIRTH
(P-09a)
If YES to P-09
In which
province was
(the person)
born?
1 =Western Cape
2 =Eastern Cape
3 =Northern Cape
4 =Free State
5 =KwaZuluNatal
6 =North West
7 =Gauteng
8 =Mpumalanga
9 =Northern
Province
COUNTRY OF BIRTH
D
CITIZENSHIP
(P-09b)
If NO to P-09
In which country was (the person)
born?
Write the present name of the country.
Use CAPITAL LETTERS only.
(P-10) (P-10a)
Is (the person) a South African
citizen?
Y = Yes
N = No
Dot the appropriate box.
If YES go to P-11
If NO
(P-10a) What is the name of the
country of citizenship?
Use CAPITAL LETTERS only.
Go to P-10
ANY WORK IN THE 7 DAYS
BEFORE 10 OCTOBER
(P-18)
In the SEVEN DAYS before
10 October did (the
person) do any work for
PAY (in cash or in kind)
PROFIT or FAMILY GAIN,
for at least one hour?
1 = Yes: formal registered
(non-farming)
2 = Yes: informal
unregistered (nonfarming)
3 = Yes: farming
4 = Yes: has work but was
temporarily absent
5 = No: did not have work
If YES go to P-19
Y
Y
ASK FOR ALL PERSONS AGED 10 YEARS AND OLDER (BORN BEFORE 1 OTOBER 1991)
D I D N O T H A V E W O R K
H A D W O R K
REASON WHY NOT WORKING
ACTIVE STEPS
AVAILABILITY
BUSINESS/COMPANY NAME
WORK STATUS
(P-18a)
(P-18b)
(P-18c)
(P-19)
(P-19a)
If NO to P-18
What is the main reason why (the
person) did not have work in the
seven days before 10 October?
1 = Scholar or student
2 = Home-maker or housewife
3 = Pensioner or retired person/
too old to work
4 = Unable to work due to illness
or disability
5 = Seasonal worker not working
presently
6 = Does not choose to work
7 = Cannot find work
If NO to P-18
In the PAST FOUR
WEEKS before
10 October has (the
person) taken active
steps to find
employment?
Y = Yes
N = No
If NO to P-18
If offered work,
how soon could
(the person) start?
1 = Within one
week
2 = More than
1 week, up
to 2 weeks
For example, (the person) 3 = More than
went to visit factories or
2 weeks, up
other employment places,
to 4 weeks
placed or answered
4 = Some time
advertisements, looked for
after 4 weeks
land or a building or
5 = Does not
equipment to start own
If more than one reason, write the code business or farm.
choose to work
of the MAIN (most important) reason.
Go to P-20
If YES to P-18
If YES to P-18
How can one best
describe (the person’s)
activities or work status?
What is the FULL name of the
business/company or organisation for
whom (the person) works?
1 = Paid employee
2 = Paid family worker
3 = Self-employed
4 = Employer
5 = Unpaid family worker
6 = Other (specify)
If the person works for him/herself, and
the business does not have a name, write
SELF in the appropriate row.
If doing PAID domestic work in a private
household, write DOMESTIC SER VICE.
Use CAPITAL LETTERS only.
N
Y
N
N
USUALLY LIVE
FIVE YEARS AGO
FROM WHERE MOVE
(P-11) (P-11a)
Does (the person) usually live in this institution for at
least four nights a week?
Y = Yes
N = No
Dot the appropriate box.
(P-12)
Five years ago (at
the time of Census
’96), was (the
person) living in
this place (i.e. this
suburb, ward,
village, farm,
informal
settlement)?
(P-12a)
If NO to P-12
If YES go to P-12
If NO
(P-11a) Where does (the person) usually live?
IF IN THE SAME PLACE as the place of enumeration, dot the
S box.
IF NOT the same place, write the PROVINCE P R ,
MAIN PLACE (city, town, tribal area, administrative area) and
SUB-PLACE (suburb, ward, village, farm, informal
settlement).
IF ANOTHER COUNTRY, write the name of the country in the
boxes below.
Y = Yes
N = No
B = Born after
October 1996
Use CAPITAL LETTERS only.
If Y or B go to P-13
Y
M
S
N
A
U
I
B
S
N
P
P
L
L
A
A
C
P
R
C
E
E
Dot the appropriate
box.
Y
N
B
IN WHICH
YEAR
(P-12b)
If NO to P-12
DISABILITY
(P-13)
Does (the person) have any
serious disability that prevents
In which year his/her full participation in life
did (the
activities (such as education,
person) move work, social life)?
to this place? Mark any that apply.
0 = None
1 = 1996
1 = Sight (blind/severe visual
2 = 1997
limitation)
3 = 1998
2 = Hearing (deaf, profoundly hard
4 = 1999
of hearing)
3 = Communication (speech
5 = 2000
impairment)
6 = 2001
Where did (the person) move from?
If more than one move, give details of the last
move.
Write the
PROVINCE P R ,
MAIN PLACE (city, town, tribal area,
administrative area) and
SUB-PLACE (suburb, ward, village, farm,
informal settlement).
If more than
one move,
write the code
for the year of
the last move.
IF ANOTHER COUNTRY, write the name of the
country.
Use CAPITAL LETTERS only.
P
R
M
A
I
N
P
L
A
C
S
U
B
P
L
A
C
E
4 = Physical (e.g. needs wheelchair,
crutches or prosthesis; limb,
hand usage limitations)
5 = Intellectual (serious difficulties in
learning)
6 = Emotional (behavioural,
psychological)
E
1
5
What does the business do (main economic
activity)?
Write the MAIN INDUSTRY, economic activity, product
or service of (the person’s) employer or company. For
example, gold mining, road construction, supermarket,
police service, healthcare, hairdressing, banking.
OR
Write the activity of the person if self- employed. For
example, subsistence farming.
Use CAPITAL LETTERS only.
2
4
3
(P-19b)
If YES to P-18
If doing PAID domestic work in a private household,
write DOMESTIC SERVICE.
Dot the appropriate boxes.
0
COMPANY/BUSINESS ACTIVITY
6
B2
ASK FOR ALL PERSONS WHO HAD WORK
OCCUPATION
HOURS
WORKED
(P-19c)
(P-19d)
If YES to P-18
If YES to P-18
What is the main occupation of (the person) in this
workplace?
Occupation refers to the type of work (the person)
performed in the seven days before 10 October.
Use two or more words.
How many
hours did (the
person) work in
the seven days
before
10 October?
For example, street trader, cattle farmer, primary school If (the person)
teacher, domestic worker, fruit vendor, truck driver,
was absent from
warehouse manager, filing clerk, etc.
work those seven
days, but usually
works, write the
number of hours
s/he usually
works.
PLACE OF WORK
(P-19e) (P-19f)
If YES to P-18
Does (the person) work in the same sub-place in
which s/he usually lives?
Y = Yes
N = No
Dot the appropriate box.
If NO, where is this place of work?
If NOT the same place, write PROVINCE P R ,
MAIN PLACE (city, town, tribal area, administrative
area) and
SUB-PLACE (suburb, ward, village, farm, informal
settlement).
If another country, write the name of the country in the
boxes below.
Y
N
P
R
M
A
I
N
P
L
A
C
S
U
B
P
L
A
C
E
E
B3
C
CENSUS 2001
QUESTIONNAIRE FOR INDIVIDUALS IN INSTITUTIONS AND TOURIST HOTELS
FOR STATISTICAL USE ONLY
FOR OFFICE USE
Institution number:
EA number:
Local council:
Homeless persons:
Province:
Main place:
dot the box
Sub-place:
Name of institution : ...................................................................................................................................
Postal code: ..........................................................
Physical address: ......................................................................................................................................
Telephone no: .......................................................
How many B Questionnaires were completed for this institution?
Total
Number of
people:
Male
Female
For institutions and tourist hotels only
(for example, tourist hotels, hospitals, childcare institutions, boarding schools, homes for the disabled, initiation
schools, convents, defence force barracks, prisons, community and church halls, refugee camps etc.)
Completion of this questionnaire
How to fill in the questionnaire
Read every question carefully.
Look at the classifications where applicable and find the alternative that
best applies to the response.
Write the codes in the appropriate boxes or dot the box.
Use a pencil. If you make a mistake, use a soft rubber to erase wrong dots,
numbers or letters and write the correct answer.
For example, in question H-27 gas belongs to category 2.
Who should be counted in Census 2001?
•
Every person young or old in South Africa on census night, 9 - 10
October, shall be counted in the institution where they spent the night.
•
Include: Babies born before 10 October 2001. Include also persons
who died after midnight between 9 - 10 October 2001.
Members of an institution who are absent overnight, for example
working, travelling or at an entertainment venue, are to be counted in
their institution if they return to it the next day, i.e. 10 October.
•
List all persons on Questionnaire C and complete one B Questionnaire for
each person in the institution, tourist hotel or for the homeless.
Please write dots, numbers and letters clearly so that the scanning machine
can read them. Always use CAPITAL LETTERS.
For example, for the use of gas as energy/fuel, write code 2 in the
appropriate box in column H-27.
Make sure that all dots, numbers and letters stay inside the box.
(Correct)
(Incorrect)
For example
1
2
3
4
5
6
7
8
9
0
SHOULD YOU ENCOUNTER ANY DIFFICULTIES IN THE COMPLETION OF THE QUESTIONNAIRE, PLEASE CONTACT
................................................................................ ON ...............................................................OR PHONE THE CENSUS HOTLINE, TOLL FREE, ON
0800 110248
C1
INSTITUTIONS
(H-23)
Which type of institution or collective living quarter is this?
00
01
02
03
04
05
06
07
08
09
10
11
12
= Tourist hotel/motel/inn
= Hospital/medical facility/clinic/frailcare centre
= Childcare institution/orphanage
= Home for the disabled
= Boarding school hostel
= Initiation school
= Convent/monastery/religious retreat
= Defence force barracks/camp/ship in harbour
= Prison/correctional institution/police cells
= Community or church hall
= Refugee camp/shelter for the homeless
= Homeless END THE INTERVIEW
= Other (specify)
Write only one code in the boxes.
ROOMS
PIPED WATER
SOURCE OF WATER
TOILET FACILITY
(H-24)
How many rooms, including kitchens, are
there for this institution?
(H-26)
In which way does this institution obtain
PIPED WATER for domestic use?
Write only one code in the box.
(H-26a)
What is this institution’s MAIN source of WATER
for domestic use? Write only one code in the box.
(H-27)
What is the MAIN type of TOILET
facility that is available for this
institution?
Write only one code in the box.
Count all rooms in all living quarters. Exclude
bathrooms, sheds, garages, stables, etc.
unless persons are living in them.
For example, if 4 rooms write 0 4 in the
box.
1 = No access to piped (tap) water
2 = Piped (tap) water on community stand:
distance greater than 200 m from
institution
3 = Piped (tap) water on community stand:
distance less than 200 m from
institution
4 = Piped (tap) water inside yard
5 = Piped (tap) water inside institution
1 = Regional/local water scheme (operated by a Water
Service Authority or Provider)
2 = Borehole
3 = Spring
4 = Rain-water tank
5 = Dam / pool / stagnant water
6 = River/stream
7 = Water vendor
8 = Other (specify)
1 = Flush toilet (connected to
sewerage system)
2 = Flush toilet (with septic tank)
3 = Chemical toilet
4 = Pit latrine with ventilation (VIP)
5 = Pit latrine without ventilation
6 = Bucket latrine
7 = None
ENERGY/FUEL
HOUSEHOLD GOODS
(H-28)
What type of energy/fuel does this institution MAINLY use for cooking, heating and
lighting? Write one code in each box.
(H-29)
Which of the following devices are available for the inhabitants of this institution and
are in working condition?
1 = Electricity
9 = Other (specify)
2 = Gas
3 = Paraffin
4 = Wood
5 = Coal
6 = Candles
7 = Animal dung
8 = Solar
Cooking
Note: - Wood (4), coal (5) and animal
dung (7) cannot be used for
lighting
- Candles (6) cannot be used for
cooking or heating
Heating
Lighting
Y = Yes
N = No
Dot the appropriate box for each item.
Y
N
Radio
Y
N
Refrigerator
Y
N
Television
Y
N
Telephone
Y
N
Computer
Y
N
Cell-phone
REFUSE OR RUBBISH
(H-30)
How is the refuse or rubbish of this institution MAINLY disposed of? Write only one
code in the box.
4 = Own refuse dump
5 = No rubbish disposal
6 = Other (specify)
1 = Removed by local authority at least once a week
2 = Removed by local authority less often
3 = Communal refuse dump
Enumerator’s name and signature(confirming that s/he has completed or checked the questionnaire).
Supervisor’s name and signature (to indicate that s/he has checked enumerator’s work)
Name: __________________________________________________________
Name: __________________________________________________________
Signature: _______________________________________________________
Signature: ________________________________________________________
Date:
D
D
M
M
Y
Y
Y
Y
Date:
D
D
M
M
Y
Y
Y
Y
C2
LIST OF PERSONS LIVING IN THIS INSTITUTION OR TOURIST HOTEL ON CENSUS NIGHT
Record number
from 09 book
(1)
Room number,
bed number or
other identifier
(2)
Surname and first initial
(3)
Tick off when
collected and
checked
(4)
Remarks
(5)
C3
LIST OF PERSONS LIVING IN THIS INSTITUTION OR TOURIST HOTEL ON CENSUS NIGHT
Record number
from 09 book
(1)
Room number,
bed number or
other identifier
(2)
Surname and first initial
(3)
Tick off when
collected and
checked
(4)
Remarks
(5)
C4
LIST OF PERSONS LIVING IN THIS INSTITUTION OR TOURIST HOTEL ON CENSUS NIGHT
Record number
from 09 book
(1)
Room number,
bed number or
other identifier
(2)
Surname and first initial
(3)
Tick off when
collected and
checked
(4)
Remarks
(5)
C5
LIST OF PERSONS LIVING IN THIS INSTITUTION OR TOURIST HOTEL ON CENSUS NIGHT
Record number
from 09 book
(1)
Room number,
bed number or
other identifier
(2)
Surname and first initial
(3)
Tick off when
collected and
checked
(4)
Remarks
(5)
C6
LIST OF PERSONS LIVING IN THIS INSTITUTION OR TOURIST HOTEL ON CENSUS NIGHT
Record number
from 09 book
(1)
Room number,
bed number or
other identifier
(2)
Surname and first initial
(3)
Tick off when
collected and
checked
(4)
Remarks
(5)
C7
LIST OF PERSONS LIVING IN THIS INSTITUTION OR TOURIST HOTEL ON CENSUS NIGHT
Record number
from 09 book
(1)
Room number,
bed number or
other identifier
(2)
Surname and first initial
(3)
Tick off when
collected and
checked
(4)
Remarks
(5)
C8
LIST OF PERSONS LIVING IN THIS INSTITUTION OR TOURIST HOTEL ON CENSUS NIGHT
Record number
from 09 book
(1)
Room number,
bed number or
other identifier
(2)
Surname and first initial
(3)
Tick off when
collected and
checked
(4)
Remarks
(5)
C9
LIST OF PERSONS LIVING IN THIS INSTITUTION OR TOURIST HOTEL ON CENSUS NIGHT
Record number
from 09 book
(1)
Room number,
bed number or
other identifier
(2)
Surname and first initial
(3)
Tick off when
collected and
checked
(4)
Remarks
(5)
C10
LIST OF PERSONS LIVING IN THIS INSTITUTION OR TOURIST HOTEL ON CENSUS NIGHT
Record number
from 09 book
(1)
Room number,
bed number or
other identifier
(2)
Surname and first initial
(3)
Tick off when
collected and
checked
(4)
Remarks
(5)
C11
LIST OF PERSONS LIVING IN THIS INSTITUTION OR TOURIST HOTEL ON CENSUS NIGHT
Record number
from 09 book
(1)
Room number,
bed number or
other identifier
(2)
Surname and first initial
(3)
Tick off when
collected and
checked
(4)
Remarks
(5)
C12